Fiscal Year 2011 DRG Weights and Rates
for DRG Numbers Between 400 and 499

Notes:

* = low volume DRG with fewer than 10 cases. The Medicare weights and LOS are used for these DRGs.

# = PM-DRGs with fewer than 10 cases. An average weight over the past 5 years were used for these DRGs.

w cc = with Complications and Comorbidities.

w/o cc = without Complications or Comorbidities

CHAMPUS Weight and Threshold Summary for FY 2011

DRG Number

Description

CHAMPUS Weight

Arithmetic Mean
Length
of Stay

Geometric Mean
Length
of Stay

Short Stay
Threshold

405

PANCREAS, LIVER & SHUNT PROCEDURES W MCC

6.1788

15.8

10.8

1

406

PANCREAS, LIVER & SHUNT PROCEDURES W CC

3.0704

7.4

6.2

1

407

PANCREAS, LIVER & SHUNT PROCEDURES W/O CC/MCC

1.8368

4.4

3.7

1

408

BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC

3.8154

10.0

8.3

2

409

BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC

2.2683

6.7

5.9

2

410

BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC

1.7087

5.8

5.2

2

411

CHOLECYSTECTOMY W C.D.E. W MCC

4.0868
*

11.8

9.9

4

412

CHOLECYSTECTOMY W C.D.E. W CC

1.8713

5.9

4.5

1

413

CHOLECYSTECTOMY W C.D.E. W/O CC/MCC

1.4260

4.0

3.4

1

414

CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC

3.0202

8.6

7.4

2

415

CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC

2.0853

5.9

5.1

1

416

CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC

1.3041

3.8

3.3

1

417

LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC

1.9923

5.0

4.0

1

418

LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC

1.6894

4.0

3.2

1

419

LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC

1.2641

2.5

2.1

1

420

HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC

4.4135

16.6

10.6

1

421

HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC

2.5789

8.7

5.6

1

422

HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC

1.2179

3.7

3.4

1

423

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC

5.9921

16.2

12.3

2

424

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC

2.1920

6.7

5.4

1

425

OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W/O CC/MCC

1.8063
*

5.7

4.4

7

432

CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC

2.0890

7.3

5.1

1

433

CIRRHOSIS & ALCOHOLIC HEPATITIS W CC

1.0872

5.3

4.0

1

434

CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC

0.6829
*

3.2

2.5

3

435

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC

1.5301

5.5

4.2

1

436

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC

1.2586

4.9

3.7

1

437

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC

1.2584

4.7

3.3

1

438

DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC

2.2308

8.1

5.9

1

439

DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC

1.0707

4.9

3.9

1

440

DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC

0.7411

3.3

2.7

1

441

DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC

2.5374

8.5

5.7

1

442

DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC

1.1311

4.6

3.5

1

443

DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC

0.6564

3.0

2.5

1

444

DISORDERS OF THE BILIARY TRACT W MCC

1.4515

4.8

3.6

1

445

DISORDERS OF THE BILIARY TRACT W CC

0.9631

3.5

2.9

1

446

DISORDERS OF THE BILIARY TRACT W/O CC/MCC

0.6916

2.3

1.9

1

453

COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC

11.3232

14.2

11.0

3

454

COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC

7.2705

5.2

4.4

1

455

COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC

5.3617

3.1

2.6

1

456

SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W MCC

7.6248

10.4

8.4

2

457

SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W CC

6.6520

6.2

5.5

2

458

SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W/O CC/MCC

5.8243

4.3

4.0

1

459

SPINAL FUSION EXCEPT CERVICAL W MCC

6.2512

7.1

6.2

2

460

SPINAL FUSION EXCEPT CERVICAL W/O MCC

4.0602

3.1

2.7

1

461

BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC

5.4817
*

8.2

6.7

3

462

BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC

3.3359

4.0

3.8

1

463

WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC

7.1312

20.8

13.6

2

464

WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC

3.4541

8.7

6.6

1

465

WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC

1.9088

4.3

3.4

1

466

REVISION OF HIP OR KNEE REPLACEMENT W MCC

5.4345

8.8

6.9

1

467

REVISION OF HIP OR KNEE REPLACEMENT W CC

3.0888

4.0

3.6

1

468

REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC

2.5388

3.2

2.9

1

469

MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC

3.1526

6.1

5.2

1

470

MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC

2.1474

3.1

2.9

1

471

CERVICAL SPINAL FUSION W MCC

4.0914

6.0

4.1

1

472

CERVICAL SPINAL FUSION W CC

2.6255

2.3

1.7

1

473

CERVICAL SPINAL FUSION W/O CC/MCC

2.0714

1.3

1.2

1

474

AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W MCC

3.9748

13.8

11.1

2

475

AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC

1.8618

7.1

5.5

1

476

AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W/O CC/MCC

1.1273

2.9

2.2

1

477

BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC

4.2174

16.5

10.6

1

478

BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC

2.5175

6.9

4.9

1

479

BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC

1.7830

3.7

2.6

1

480

HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W MCC

3.3865

7.2

5.9

1

481

HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC

2.2378

5.3

4.6

1

482

HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC/MCC

1.5555

3.2

2.6

1

483

MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W CC/MCC

2.7277

3.0

2.5

1

484

MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W/O CC/MCC

1.9641

1.9

1.7

1

485

KNEE PROCEDURES W PDX OF INFECTION W MCC

2.6631

8.2

7.3

2

486

KNEE PROCEDURES W PDX OF INFECTION W CC

2.3673

7.3

5.9

1

487

KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC

1.2637

4.2

3.8

1

488

KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC

1.4872

3.1

2.8

1

489

KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC

1.2966

2.1

1.8

1

490

BACK & NECK PROC EXC SPINAL FUSION W CC/MCC OR DISC DEVICE/NEUROSTIM

2.0928

3.1

2.2

1

491

BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC

1.1762

1.5

1.3

1

492

LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W MCC

3.7089

8.5

6.5

1

493

LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC

2.1035

4.3

3.5

1

494

LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC/MCC

1.4121

2.6

2.2

1

495

LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W MCC

3.8876

9.8

5.2

1

496

LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC

1.5981

4.0

3.1

1

497

LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W/O CC/MCC

1.1749

2.1

1.6

1

498

LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W CC/MCC

1.9931

4.8

3.5

1

499

LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W/O CC/MCC

0.9457

2.0

1.6

1

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